[Hepatic metastasis of colorectal cancer. Should it be surgically treated? Report of 55 cases].
Surgical resection currently represents the best chance of improving survival for some patients with hepatic metastases (H.M.) of colorectal origin. Out of a total of 288 patients with H.M. from colorectal cancer, 55 only had a surgical exeresis (hepatectomy or removal of the metastasis). These were 36 cases of synchronous H.M. and 19 of metachronous H.M. The operative mortality is as high as 2%. The overall actuarial survival rate at 5 years is 19.6%. The single-factor analysis of the factors connected with survival reveals 2 deciding factors: the margin of normal peritumoral hepatic parenchyma resected (p less than 0.01) and the degree of tumoral differentiation (p less than 0.05). A preoperative CEA level higher than 30 ng/l may be a pejorative factor (p less than 0.05). The results of this series are likely to be improved: 1 degree by a better selection of the patients scheduled for resection, especially as it is necessary to extend resection into the normal parenchyma more than 1 cm from the tumor, and 2 degrees by the addition of an adjunctive regional chemotherapy.
Adloff
M
M
Centre Médico-chirurgical, Schiltigheim.
Arnaud
J P
JP
Thebault
Y
Y
Ollier
J C
JC
Schloegel
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012004:Rectal Neoplasms / Q000473:pathology*
Métastases hépatiques des cancers colo-rectaux. Faut-il être interventionniste? A propos de 55 cas.